CRCR Certification VERIFIED SOLUTIONS 100%

CRCR Certification VERIFIED SOLUTIONS 100% Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by - ANSWER The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid - ANSWER Meet Income and Assets Requirements In choosing a setting for patient financial discussions, organizations should first and foremost - ANSWER Respect the patients privacy A nightly room charge will be incorrect if the patient's - ANSWER Transfer from ICU (intensive care unit) to the Medical/Surgical floor is not reflected in the registration system The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals and small businesses can - ANSWER Purchase qualified health benefit plans regardless of insured's health status A portion of the accounts receivable inventory which has NOT qualified for billing includes: - ANSWER Charitable pledges What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare? - ANSWER Revenue codes This directive was developed to promote and ensure healthcare quality and value and also to protect consumers and workers in the healthcare system. This directive is called - ANSWER Patient bill of rights The activity which results in the accurate recording of patient bed and level of care assessment, patient transfer and patient discharge status on a real-time basis is known as - ANSWER Case management Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? - ANSWER Registration staff may routinely contact managed are plans for prior authorizations before the patient is seen by the on-duty physician HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions to identify the employer of an individual described in a transaction EIN's are assigned by - ANSWER The Internal Revenue Service Checks received through mail, cash received through mail, and lock box are all examples of - ANSWER Control points for cash posting What are some core elements if a board-approved financial assistance policy? - ANSWER Eligibility, application process, and nonpayment collection activities A recurring/series registration is characterized by - ANSWER The creation of one registration record for multiple days of service With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of Medicaid in some states, it is more important than ever for hospitals to - ANSWER Assist patients in understanding their insurance coverage and their financial obligation The purpose of a financial report is to: - ANSWER Present financial information to decision makers Patient financial communications best practices produce communications that are - ANSWER Consistent, clear and transparent Medicare has established guidelines called the Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) that establish - ANSWER What services or healthcare items are covered under Medicare Any provider that has filed a timely cost report may appeal an adverse final decision received from the Medicare Administrative Contractor (MAC). This appeal may be filed with - ANSWER The Provider Reimbursement Review Board Concurrent review and discharge planning - ANSWER Occurs during service Duplicate payments occur: - ANSWER When providers re-bill claims based on nonpayment from the initial bill submission An individual enrolled in Medicare who is dissatisfied with the government's claim determination is entitled to reconsideration of the decision. This type of appeal is known as - ANSWER A beneficiary appeal Insurance verification results in which of the following - ANSWER The accurate identification of the patient's eligibility and benefits The Medicare fee-for service appeal process for both beneficiaries and providers includes all of the following levels EXCEPT: - ANSWER Judicial review by a federal district court Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not ask about a patient's insurance information if it would delay what? - ANSWER Medical screening and stabilizing treatment Ambulance